NHS services need a “fundamental overhaul,” with funding shifting from hospitals to primary care and a reorganisation of staff working patterns, the NHS Confederation believes.

In his New Year message the confederation’s chief executive, Mike Farrar, said that the NHS needed to change to cope with the changing demands placed on it. “NHS leaders know that a fundamental overhaul is necessary to make our health service fit for the future,” he said.

Farrar argued that the NHS needed to “provide more investment in primary, community, mental health, and social care services as a proportion of the total spend.

“Increasing money in these areas will help keep people out of hospital and leading independent lives, accessing care in their own homes or closer to home.”

The NHS Confederation also believes that NHS working patterns need to change if services are to improve. “The NHS can provide better care, better value, and better outcomes by changing the way it provides care,” Farrar said. “This means concentrating specialist expertise on fewer sites to enable patients to have access to the best round the clock intensive care.”

Farrar also said in his message that NHS leaders and politicians needed to be open with the public about changes to the NHS. “NHS leaders know that a fundamental overhaul is necessary to make our health service fit for the future,” he said. “No decisions about the way our health service should look in the future should be made without serious public debate and scrutiny,” he added.

The NHS Confederation has also set out a series of actions that it believes the public should undertake to help the health service. These include taking time to understand the way the health service is changing and helping to reduce demand on services.